Original article: general thoracicVideo-assisted thoracic surgery for pure ground-glass opacities 2 cm or less in diameter
Section snippets
Patients and methods
Between January 2000 and February 2002, VATS was performed for 39 patients with 62 well-circumscribed nodules less than or equal to 2 cm in diameter, with greater than or equal to 98% GGO content on HRCT. To exclude findings of GGO attributable to inflammation, follow-up of GGO was undertaken for at least three months, and VATS resection was planned if lesion size or density increased or remained unchanged. Patients displaying GGO in combination with nodular-type lung cancer were excluded from
Results
Single lesions were identified in 30 patients, with multiple lesions (mean, 4 lesions; range, 2 to 7 lesions) in nine. One patient with multiple lesions displayed bilateral disease. Patient characteristics are listed in Table 1. All patients were asymptomatic, with GGO detected on helical CT during screening for lung cancer, or on CT investigation of other conditions. Preoperative percutaneous CT-guided localization using VATS markers was performed for 39 GGOs in 30 patients (77%). No serious
Comment
Recently, cases of small LBAC presenting with GGO have increased in Japan, due to the introduction of helical CT in screening for lung cancer. The present paper discusses the efficacy of limited surgical resection of LBAC, presenting as pure GGO on HRCT 1, 2, 3, 4, 5, 6, 19. Regarding surgical treatment of peripheral lung cancer, small tumor size alone does not represent a sufficient indication for limited surgery. Even small-sized tumors have the potential for mediastinal lymph node
References (19)
- et al.
Early results of a prospective study of limited resection for bronchioloalveolar adenocarcinoma of the lung
Ann Thorac Surg
(2001) - et al.
Natural history of pure ground-glass opacity after long-term follow-up of more than 2 years
Ann Thorac Surg
(2002) - et al.
Prognostic significance of the size of central fibrosis in peripheral adenocarcinoma of the lung
Ann Thorac Surg
(2000) - et al.
Radiologic-prognostic correlation in patients with small pulmonary adenocarcinomas
Lung Cancer
(2002) - et al.
Incidence of local recurrence and second primary tumors in resected stage 1 lung cancer
J Thorac Cardiovasc Surg
(1995) - et al.
Randomized trial of lobectomy versus limited resection for T1N0 non-small cell lung cancer
Ann Thorac Surg
(1995) - et al.
Bronchioloalveolar carcinoma of the lungrecurrences and survival in patients with stage 1 disease
J Thorac Cardiovasc Surg
(2001) - et al.
Needle localization of peripheral lung nodules for video-assisted thoracoscopic surgery
Chest
(1994) - et al.
The hook-wire technique for localization of pulmonary nodules during thoracoscopic resection
Chest
(1994)
Cited by (79)
“HRCT predictors of GGO surgical resection: Histopathological and molecular correlation in the era of lung sparing surgery”
2022, Lung CancerCitation Excerpt :Though progression rate of the subsolid GGOs toward an invasive adenocarcinoma with clinical effect is extremely slow, the recognition of the natural history of subsolid GGOs is mandatory for an appropriate management: radiological follow-up versus surgical resection [17]. This is particularly relevant considering the positive prognosis in case of surgical resection for “pure GGOs” for which several retrospective studies reported survival rates of about 100% [18–21]. In this scenario the aim of this study is to evaluate the correlation between the GG pattern at HRCT and the lepidic pattern at the histopathological examination, investigating the association between the proliferation index and pathologic lymph-nodal status according to the percentage of GG component.
Approach to the Subsolid Nodule
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